Blood Pressure Control Among Diabetes Patients Within a Managed Care Setting

Abstract

Blood pressure (BP) control is a key component of diabetes management. BP control in patients with diabetes was assessed across 4 Colorado health plans. BP was obtained through retrospective chart reviews, and BP control was defined as <130/80 mm Hg. The study included 1445 diabetic patients in 2004 and 1423 diabetic patients in 2005. BP control did not improve significantly from 2004 to 2005; in 2004, 33.1% had controlled BP, compared with 35.2% in 2005. Women were more likely to have controlled BP than men, and younger patients were more likely to have controlled BP than older patients. Two of the 4 plans showed significant improvement in BP control, whereas the proportion of patients with BP controlled declined in 2 health plans. More aggressive disease management and pharmacologic treatment of blood pressure is needed to improve the cardiovascular health of patients with diabetes. (Am J Med Qual 2008;23:201-207)

Keywords

diabetes hypertension blood pressure control managed care HEDIS

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References

Cowie CC , Rust KF , Byrd-Holt DD , Eberhardt MS , Flegal KM , Engelgau MM Prevalence of diabetes and impaired fasting glucose in adults in the U.S. population. Diabetes Care. 2006;29:1263-1268.

American Diabetes Association. Economic costs of diabetes in the U.S. in 2002. Diabetes Care . 2003;26:917-932.

National Diabetes Information Clearinghouse. National Diabetes Statistics. http://diabetes.niddk.nih.gov/dm/pubs/statistics/#7. Accessed February 7, 2007.

Schernthaner G. Cardiovascular mortality and morbidity in type 2 diabetes mellitus. Diabetes Res Clin Pract. 1996;31: S3-S13.

Chobanian A. , Bakris G. , Black H. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 report. JAMA. 2003;289:2560-2572.

Resnick HE , Foster GL , Bardsley J. , Ratner RE Achievement of American Diabetes Association clinical practice recommendations among US adults with diabetes, 1999-2002. Diabetes Care. 2006;29:531-537.

National Committee for Quality Assurance. HEDIS 2004: Health Plan Employer Data and Information Set. Washington, DC: National Committee for Quality Assurance ; 2004.

National Committee for Quality Assurance. The State of Health Care Quality 2006. Washington, DC: National Committee for Quality Assurance; 2006.

National Committee for Quality Assurance. HEDIS 2007. Vol 2. Washington, DC: National Committee for Quality Assurance; 2007.

10.

National Committee for Quality Assurance. Version 3 NCQA Quality Compass. http://web.ncqa.org/QualityCompass.aspx. Accessed August 28, 2007. The source for data contained in this publication is Quality Compass® and is used with the permission of the National Committee for Quality Assurance ("NCQA"). Any analysis, interpretation, or conclusion based on these data is solely that of the authors, and NCQA specifically disclaims responsibility for any such analysis, interpretation, or conclusion. Quality Compass is a registered trademark of NCQA.

11.

National Committee for Quality Assurance. HEDIS 2004. Vol 2. Washington, DC: NCQA; 2003.

12.

U.S. Department of Health and Human Services. Healthy People 2010. 2nd ed. With Understanding and Improving Health and Objectives for Improving Health. Washington, DC: U.S. Government Printing Office; 2000.

13.

Godley PJ , Maue SK , Farrelly EW , Frech F. The need for improved medical management of patients with concomitant hypertension and type 2 diabetes mellitus. Am J Manag Care. 2005;11:206-210.

14.

Siomos EE , Newsom RS , Camponeschi J. , Remington PL A statewide collaboration to monitor diabetes quality improvement among Wisconsin health plans. Am J Manag Care. 2005;11:332-336.

15.

McBean AM , Jung K. , Virnig BA Improved care and outcomes among elderly Medicare managed care beneficiaries with diabetes. Am J Manag Care . 2005;11:213-222.